| NPI | 1225813983 |
|---|---|
| Doing Business As | RIVER VALLEY DENTAL |
| Entity Type | Organization |
| Authorized Contact | SHANE MATTHEW WELLINGTON Dentist/Owner 330-385-1352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2023-08-30 |